Clinical decision-making regarding communication book use by people with aphasia: a survey of speech and language therapists in Ireland

Aim:The purpose of this study was to investigate clinical decision-making relating to Communication Book (CB) use by people with aphasia following stroke in Ireland. Method: A 20-question online survey was sent to 518 Speech and Language Therapists (SLTs) in Ireland, of which, 46 provided data for this study. Quantitative and qualitative responses were received in relation to demographic information, types of CB’s used and for what purposes, who uses them, who is involved in the development of CB’s, facilitation of generalisation, and evaluation of efficacy. Results: Results show that the most popular type of CB used is a tailor-made version with personalised vocabulary. Photographs and pictographs are the most common type of content. Low-technological devices are used more than high-technological devices. Clinicians agree that it is more important to use CB’s with people with severe or chronic aphasia. The main measurements of efficacy used by clinicians are levels of user’s and communication partner’s satisfaction. Qualitative results highlight that lack of support/ motivation from primary communication partners is the main perceived reason for failure/ abandonment of CB use in this population. Conclusions: Findings indicate a high degree of consistency between current research and current practice by SLTs using CBs with people with aphasia in Ireland, and reiterate the importance of communication partners’ involvement to successful CB use. This study also adds new findings to evidence-based practice in this field of AAC (e.g. perceived importance to timing of introduction of CB following stroke)